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Because depression does not remit with treatment in about two thirds of patients, clinicians eagerly seek guidance for enhancing improvement. These researchers explored possible moderators of remission in a reanalysis of data from a 12-week single-blind trial involving 1522 veterans with major depression and suboptimal response to a selective serotonin reuptake inhibitor, a serotonin–norepinephrine reuptake inhibitor, or mirtazapine (NEJM JW Psychiatry Sep 2017 and JAMA 2017; 318:132).
Most participants were men (85%), white (69%), and relatively old (mean age, 54) and had recurrent disorder (63%), with mean measurement scores indicating severe depression (mean duration of current episode, 87 months). They had been randomized to switch to su…